Individual provider Active NPI

Miranda Goode Ferreira, DPT

  • Physical Therapist
  • St Augustine, FL
National Provider Identifier
1992971352
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT29127 Issued in FL
Practice address
319 W Town PL
Suite 5
St Augustine, FL 32092-3101
Phone
(904) 342-5262
Fax
(904) 217-3580
NPI assigned
May 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT29127 FL Primary

Addresses

Primary practice location

319 W Town PL
Suite 5
St Augustine, FL 32092-3101

Mailing address

188 Wild Egret LN
St Augustine, FL 32086-9012
Phone (225) 718-0013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1992971352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 WILD EGRET LN",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320869012",
            "telephone_number": "225-718-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 W TOWN PL",
            "address_2": "SUITE 5",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923101",
            "telephone_number": "904-342-5262",
            "fax_number": "904-217-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERREIRA",
        "first_name": "MIRANDA",
        "middle_name": "GOODE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT29127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.